Publication year
2010
Citation Title
Wartime military deployment and increased pediatric mental and behavioral health complaints.
Journal Name
Pediatrics
Journal Volume
126
Issue Number
6
Page Numbers
1058–1066
DOI
10.1542/peds.2009-2856
Summary
Researchers aimed to determine the effect of parental military deployment on the relative rate of outpatient visits for mental and behavioral health disorders in children aged three to eight years. Children with a deployed parent had a higher rate of outpatient visits for some mental health and behavioral health issues, but not all. This is particularly true for older children with deployed fathers.
Key Findings
Medical records documented that children, between ages three and eight, with a deployed parent increased their outpatient mental and behavioral health visits by 11%; reported behavioral disorders increased 19% and stress disorders increased 18%.
Mental health and behavioral conditions came to clinical attention at higher rates during parental military deployment for older (compared to younger) children, for children of married (compared to single) parents, and for children of male (compared to female) military Service members.
The severity and significance of the increased rates is important when considering the general 11% decrease in all health care visits for this population when a parent was deployed.
Implications for Program Leaders
Continue to offer additional supports and resources for addressing children’s behavioral issues and reducing children’s stress during parental deployment
Offer workshops to military parents regarding normative children's responses to deployment with consideration for childs age and the stage of deployment
Distribute information regarding resources and services available to military families during the deployment cycle
Implications for Policy Makers
Continue to support services that help families with children during deployments
Recommend age based health screening for adjustment issues (in a school or health provider setting) to identify early adjustment problems and offer referrals
Recommend training for service providers who work with military families regarding the impact of deployment on children's mental and behavioral health
Methods
This was a retrospective cohort study. Records of children of Active Duty personnel during fiscal years 2006 and 2007 were linked with their parent’s deployment records.
Mental and behavioral health visits were identified by using codes form the International Classification of Diseases, 9th Revision.
This study focused on Active Duty military parents. Children of National Guard or Reserve personnel were excluded.
Participants
The sample comprised 642,397 children aged three to eight years and 442,722 military parents, 32% deployed during the study.
The mean age of children in the sample was 5 years (SD = 1.9 years); 51% were male, and 68% were White.
The majority of military parents were male (90%) and senior enlisted (66%); parents served in the Army (45%), Air Force (26%), Navy (13%), and Marines (7%).
Limitations
This study focuses on Active Duty Service members; hence, results may not generalize to National Guard or Reserve personnel.
Parental mental health conditions were not factored into the analyses, which may have biased the data (e.g., extant research suggests that depressed mothers perceive their children’s mental health problems more frequently than non-depressed mothers).
The study did not did not subcategorize military deployments into pre-deployment, deployment or post-deployment phases; there may be specific periods in a deployment cycle when certain mental or behavioral health complaints are more likely to surface.
Avenues for Future Research
Conduct longitudinal studies to determine if the effects of deployment on parent-child separation persist into adulthood
Control for parental mental health conditions while calculating the impact of deployment on child behavioral and mental health
Distinguish between the effects of multiple and/or extended deployments and deployment length, as well as potential differences between the effects of the pre-deployment, deployment, and post-deployment phases of the deployment cycle
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Children of military personnel face stress when a parent deploys. OBJECTIVE: Our goal was to determine the effect of parental military deployment on the relative rate of outpatient visits for mental and behavioral health disorders in children aged 3 to 8 years. METHODS: This was a retrospective cohort study. Records of children of active-duty personnel during fiscal years 2006 and 2007 were linked with their parent's deployment records. Mental and behavioral health visits were identified by using International Classification of Diseases, Ninth Revision, codes. The incidence rate ratio (IRR) of visits per year according to parental deployment status was determined with random-effects negative binomial regression modeling with longitudinal data analysis. RESULTS: A total of 642,397 children aged 3 to 8 years and 442,722 military parents were included. Mean child age was 5.0 years (SD: 1.9 years); 50.6% were male, and 68.0% were white. Ninety percent of the parents were male, and 90.5% were married; 32.0% of the parents were deployed during the study. There were 1,049,081 person-years with 611 115 mental and behavioral health visits (0.6 visit per year). The IRR of mental and behavioral health visits for children with a deployed parent compared with when a parent was home was 1.11 (95% confidence interval [CI]: 1.07–1.14; P < .001). IRRs of pediatric anxiety, behavioral, and stress disorders when a parent deployed were 1.14 (95% CI: 0.98–1.32; P = .095), 1.19 (95% CI: 1.07–1.32; P < .001), and 1.18 (95% CI: 1.10–1.26; P < .001), respectively. Older children and children with military fathers and married parents had larger increases in rates of mental and behavioral health visits during parental deployments. In contrast, the overall outpatient rate and rates of visits for other diagnoses decreased when a parent was deployed. CONCLUSIONS: Mental and behavioral health visits increased by 11% in these children when a military parent deployed; behavioral disorders increased 19% and stress disorders increased 18%. Rates especially increased in older children and children of married and male military parents.
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